Abstract
This is a report of the case of an 18 year-old woman who was admitted to a psychiatric hospital for anorexia nervosa. After admission, hypoglycemic coma developed as a complication, and although she recovered from the coma in response to intravenous glucose administration, an ultrasonic echocardiogram (UCG) demonstrated takotsubo cardiomyopathy. Because the patient's serum phosphate level had decreased to 0.9 mg·dl−1, she was diagnosed with refeeding syndrome and admitted to the ICU. Artificial feeding (both enteral and parenteral), early supplementation with phosphorous, and other electrolytes were started at a reduced calorific rate. The patient recovered, and she was discharged to a general ward on ICU day 16. When nutrition is started after prolonged starvation, it is important to start at a reduced calorific rate and to monitor vital signs, electrolyte levels, and water balance closely in order to prevent refeeding syndrome.
